安徽省疟疾局限性暴发流行影响因素通径分析.pdfVIP

2004羁MPH 安徽镘疟疾局限性暴发漉{丁影响民索的通{李分析 和12．0％(3／25)。乡村卫生人员疟疾专业知识测试结果显示，平均正确回答率为51．7％， 表明基层人员疟疾专业知识较欠缺。通径分析显示，社会因素中居民露宿行为对疟疾 发病的直接贡献最大为0．3957，其次是防蚊设施使用(一0．2087)，但后者与疟疾发病 呈负关联；气象因素中，温度对疟疾暴发流行的直接作用最大，为0．5057，降雨量 通过气温所起的间接作用最大，为0．3954。 结论气温上升，使疟疾流行季节延长；流行季节雨量增多，增加了媒介孳生场 所，使蚊虫密度上升；当地居民的露宿习惯，增加了感染疟疾的危险；居民免疫水平 低下，自我保护意识薄弱；大牲畜存栏数急剧减少，有效的动物保护屏障遭到破坏； 疟疾病例发现和治疗不及时等，是促成淮河以北地区疟疾局限性暴发流行的主要原 因。 【关键词】 疟疾；流行；现状；暴发流行；原因；通径分析 2 2004磊MPH安徽省瘿疾舄限性暴发流行影响闲素的透径分析 A Path Analysis on the Factors Impacting Local Malaria Epidemic in Anhui Province Abstract Objective To evaluate the direct and indi rect impact of relevant social and climate factors in malaria epidemic SO as to provide a basiS for improving control strategy in Anhui Province，through a path analysiS in combination with the current situation of malaria and a field investigation． Methods Descriptive epidemiological method was used to analyze the time and spatial distribution of malaria incidence during 2000—2006 in the province． RepresentatiVe areas with malaria epi demic were selected for the field investigation．Fi lter paper dry blood samples were col lected from 571 inhabitants for detecting antibody level by indirect fluorescent antibody test(IFAT)to examine the immune status among the residents．Questionnairing was performed for 548 inhabitants，covering malaria history in the past 2 years， knowledge on malaria and its control，use of mosquito nets／curtains，outdoor sleeping habit，and behavior of the patients wi th fever in seeking medical service，to analyze their awareness on self—protection．The knowledge level and technical capac i ty of the health workers at the primary heal th care(PHC) level were evaluated by interviewing，questionnairing and test．Correlation analysiS，multi—regression analysis etnd path analysiS were applied to estimate the direct and indirect role of SOCial and C1 imate factors in malaria incidence，and their relative significance． Results An increasing tendency of malaria incidence in the province was recorded from